AB1216 SYMPTOMATIC SLOW-ACTING DRUGS FOR GONARTHROSIS: BETWEEN EXPECTATIONS AND REALITY
Authors: H. Tebaa, H. Arabi, A. Mougui, I. El Bouchti
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Osteoarthritis of the knee is the most common cause of chronic pain and disability in patients. In addition to non-steroidal anti-inflammatory drugs and analgesics, the symptomatic slow-acting anti-arthritic drugs (SAALs) define a specific class of medications used in the symptomatic treatment of osteoarthritis of the knee. With a delayed effect, this family of drugs is used to reduce the intensity of pain and functional discomfort caused by the destruction of cartilage. <h3>Objectives</h3> The objective of this study was to evaluate the fears and expectations of patients before the treatment and the response to the treatment as well as the degree of satisfaction after one year of treatment. <h3>Methods</h3> This study was conducted in the form of an individual questionnaire, 56 patients followed in consultation for a primary gonarthrosis without a period of congestive attack, the diagnosis of knee osteoarthritis was made by and radiography of the knee according to the classification of Kellgren and Lawrence, any patient with secondary osteoarthritis or very disabling gonarthrosis was excluded. Patients were questioned about their fears and expectations before the start of treatment. An evaluation of the therapeutic response after one year was done by different parameters: the visual analogue pain scale (VAS pain), the Lequesne index of the knee, and decrease in analgesic consumption, improvement in walking perimeter and side effects and pain reduction. Global satisfaction was evaluated by a likert scale composed of 7 degrees of satisfaction (from extremely satisfied to extremely dissatisfied). <h3>Results</h3> We included 56 patients, the average age was 44 years, the female sex represented 59%, the average educational level represented 20%. According to the classification of Kellgren and Lawrence, stage 2 represents (40%), stage 3 (52%) and stage 4 (8%). There were 30% of patients on chondroitin-based antiarthritis drugs, 60% on glucosamine and 10% on avocado-soybean unsaponifiable extract. The average VAS pain was 5 ± 1.1, the average Lequesne index (knee) was 7. Fear of pain exacerbation was noted in 15%, 20% were afraid of a functional handicap and 49% were afraid of a probable surgery, 16% had no fear. Before the initiation of treatment, 65% of the patients hoped for an improvement in their function, 49% feared a probable surgery and 16% had no fear. Before the initiation of treatment, 35% thought it was a placebo. The mean VAS pain after treatment was 3±2.2 vs 5 ±1.1 before treatment (p= 0.003), the mean Lequesne index after treatment was 4.9 vs 7 after treatment with a statistically significant difference (p= 0.003), an improvement of the gait perimeter was noted in 51%, 41% reported a reduction in the consumption of analgesics, 3% of patients had side effects such as nausea and and vomiting. After 1 year of treatment, 45% of patients were extremely satisfied with their treatment, 15% were extremely dissatisfied, 10% were satisfied and 30% were not very satisfied. <h3>Conclusion</h3> Patient expectations and satisfaction are important components in the evaluation of quality of care. This new approach is important to guarantee therapeutic adherence. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.